Lasiodiplodia keratitis: A case series of 27 patients.

Purpose: To review 27 cases of microbial keratitis caused by Lasiodiplodia theobromae presenting to a tertiary eye care center in eastern India over seven-year period and analyze the risk factors, clinical profile, microbiological characteristics, treatment, and outcome of patients.

Method: This is a retrospective review of 27 cases of microbial keratitis diagnosed with Lasiodiplodia theobromae between November 2015 and October 2022. Data were retrieved using the electronic medical record system. Additional outcomes such as average time of resolution, frequency, type, and outcome of surgical interventions, wherever performed, were also analyzed. Descriptive statistics were used to interpret the demographic data.

Results: The mean age of patients was 56.8 ± 18.7 years (range: 23-86), the male: female ratio was 2.4:1, and the average follow-up was 90.2 days. Eleven (40.7%) patients had a history of trauma, and 16 (59.3%) presented with a large infiltrate (>6 mm). Samples from all the patients were culture-positive for Lasiodiplodia theobromae, of which 26 (96.3%) were corneal scrapings and one (4%) was a half-corneal button. Eight (29.6%) patients had coexisting bacterial infections. Successful management was achieved in 12 eyes (66.7%) with medical treatment alone (topical natamycin, n = 7; topical natamycin + oral ketoconazole, n = 3; and topical natamycin + topical gatifloxacin, n = 2). However, surgical intervention was required for nine (33.3%) eyes.

Conclusion: Medical management with natamycin was effective in treating patients with Lasiodiplodia keratitis. However, advanced cases necessitated surgical intervention for complete resolution.